| NPI | 1356912497 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: NC 5019545) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: CO 0996679-NP) |
| Enumeration Date | 2021-07-09 |
| Last Update Date | 2024-05-08 |